Yang Jin, Tang Yongfeng, He Huabin, Fu Shangjun
Department of hand and foot surgery, Yiwu Central Hospital, Jiangdong Road 699#, Yiwu city, Zhejiang province, China.
Rev Assoc Med Bras (1992). 2018 Jun;64(6):501-508. doi: 10.1590/1806-9282.64.06.501.
To report the surgical procedures and efficacy of using medial plantar venous flap for the repair of soft tissue defects of the fingers.
From March 2010 to April 2012, medial plantar venous flaps were harvested to repair the wounds of 31 fingers in 29 cases. Among them, there were 13 middle fingers with defects at the tips in 11 cases, 7 fingers with defects in the dorsal part in 7 cases, and 11 fingers with defects in the finger pulp in 11 cases. The size of the defects ranged from 1.2cm×1.5 cm to 2.5cm × 3.5cm. Medial plantar venous flaps of 1.5cm × 2cm - 3×4 cm were harvested. Full-thickness skin grafts were adopted for the donor areas.
All 31 flaps survived, except for 1 flap with arterial crisis and 2 cases with venous crisis. These conditions were timely corrected by secondary anastomosis of artery and vein and the flaps survived. The wounds and the donor areas achieved healing by the first intention. All grafted skins survived. Postoperative follow-up was conducted for 26 fingers in 24 cases for 4-12 months, excluding 5 cases with lost follow-up. The dorsal part of the damaged fingers had normal morphology, and the skin color and texture were similar to those of the normal skin. After the repair of defects in the fingertip and pulp, fingerprints appeared, and the protective sensation was restored.
The soft tissue defects of the fingers can be satisfactorily repaired with medial plantar venous flap, and little damage is caused to the donor area. This method is proven effective for the repair of soft tissue defects of the fingers.
报道采用足底内侧静脉皮瓣修复手指软组织缺损的手术方法及疗效。
2010年3月至2012年4月，采用足底内侧静脉皮瓣修复29例患者的31个手指创面。其中，11例患者的13个中指指尖缺损，7例患者的7个手指背侧缺损，11例患者的11个手指指腹缺损。缺损大小为1.2cm×1.5 cm至2.5cm × 3.5cm。切取面积为1.5cm × 2cm - 3×4 cm的足底内侧静脉皮瓣。供区采用全厚皮片移植。
31个皮瓣中，除1个皮瓣发生动脉危象，2例发生静脉危象外，其余皮瓣全部成活。经再次动静脉吻合及时纠正后，皮瓣成活。创面及供区均一期愈合。所有移植皮片全部成活。对24例患者的26个手指进行了4 - 12个月的术后随访，5例失访除外。伤指背侧形态正常，皮肤颜色和质地与正常皮肤相似。指尖及指腹缺损修复后，指纹出现，保护性感觉恢复。
足底内侧静脉皮瓣可满意修复手指软组织缺损，对供区损伤小。该方法对修复手指软组织缺损有效。
